Choices for Living Well (Killelea)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 92 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider operated a Single Point of Access (SPOA) referral system for all prospective new admissions into the service. Comprising of admission coordinators and members of MDT, we saw how this system supported safe, effective and timely admissions from both the community and acute hospital settings.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

A truly standout feature of the service was the comprehensive MDT approach, providing outstanding evidence-based practice. During the assessment we sat in on a daily ‘board round’ meeting which showcased excellent collaborative working. Managers, registered nurses, senior support workers, technical instructors, physiotherapists, occupational therapists, the social work team, wellbeing practitioners, the pharmacy team, consultant geriatrician (a senior doctor, specialising in the care of older people) and advanced clinical practitioners all worked seamlessly together. This provided a strong example of how NHS and adult social care professionals, co-located and working as one, can deliver exceptional, evidence-based care, support and rehabilitation.

The consultant geriatrician told us, “I think people have the best chance to improve here and be looked after very well. I would be happy to have a loved one/family member in Killelea or myself for that matter!”. A social care professional also commented, “It is one of the best examples of intermediate care that I know of. The fact adult social care and health is delivered in partnership, and as one, is key, and it works!.” Comments from people included, “I get physio every day and they are working wonders with me, they all work really hard to get you back on the road to recovery again.”

In 2023, the provider entered a new partnership with a local business, who owned and operated the café bar adjacent to the service. This collaboration meant people receiving their rehabilitation and support could also access the café as their part of their rehabilitation either with friends and family or independently. The offer was further enhanced when the café started to provide a catering service to the whole service, offering a hot lunch time meal and a lighter option at teatime. Comments from people included, “The food is good and you get a choice” and “The food is very good on the whole and comes piping hot.” Staff also worked together to ensure peoples dietary requirements were met. A relative explained to us that since being admitted into the service, their loved one had started to eat food again that was appropriate to their religious and cultural beliefs. This came after the person had been put off from ordering such food whilst in hospital as it was ‘unappetising and tasteless’ and had not met their needs.

The collaboration with the onsite café went beyond food and drink. The business owner also ran weekly community events that were open to all. These included a ‘Crafty Catch Up’ and ‘Family Craft’ all helping people to measure their progress and start to regain independence. We obtained feedback from the café owner who told us, “We love working in collaboration with the Killelea team as it fits with our social values and ethos of providing opportunities for the community to come together for many different reasons."

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

Within the providers ‘intermediate tier’ people were able to move seamlessly between services. For example, some people moved from the ‘bed-based’ setting at Choices for Living (Killelea) to ‘home based’ services so support could continue in their own home. Staff and teams frequently rotated which helped to maintain a strong MDT approach. Relevant and up-to-date information was readily available to the whole MDT which avoided duplication and genuinely meant people only needed to tell their story once wherever possible.

We saw a moving testimony provided by a relative of a person who used the service, in which they had they said: “I just wanted to thank your wonderful service and fabulous staff for the care and support provided to my mum during her time at Killelea and Reablement. I have always known Choices for Living Well is an excellent service. After mums, fall, when she arrived at Killelea I wondered what mobility she’d regain, but with the support from the physios, occupational therapists and care staff and with her own determination to be independent, she made huge progress. As a family we feel if she had not gone to Killelea her recovery would have taken much longer.”

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The consultant-led ‘ward round’ was completed in the service at least twice a week. We saw how this was helping to ensure peoples ongoing medical needs were addressed in tandem with their rehabilitation goals. A registered nurse who worked in the service told us, “Having the consultant and his team fully emersed in the service is fantastic. It means we can respond to people’s needs in a more holistic way, including safely reducing the number of medicines people are taking on discharge.” A relative told us, “The doctor who comes round weaned [Person] off some of their medication and she has been so much better.”

We saw how people were supported and encouraged to live healthier lives and where possible, reduce their future need for care and support. For example, during Falls Prevention Week, staff actively supported people to live healthier and safer lives by delivering a structured programme of falls prevention activities focused on education, mobility, and confidence building. Staff provided evidence-based balance and strength sessions (OTAGO classes) alongside individual mobility assessments and personalised advice on home safety and equipment use. These interventions enabled people and their relatives to better understand their own fall risks, improve functional ability, and adopt healthier routines that promoted long term independence. The team worked collaboratively across all disciplines, ensuring consistent messaging and tailored support to people and family members, providing preventative, person centred care that enhanced overall wellbeing and helped to reduce avoidable harm. When people left the service they could continue with their OTAGO classes by being referred the to Bury BEATS service to maintain their abilities and enable a continued level of independence.

The service monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and they fully met both clinical and social care expectations and the expectations of people themselves.

The therapy teams used evidence-based assessment tools and database systems to track and monitor progress, including positive outcomes. For example, The Barthel Index used to measure functional independence in Activities of Daily Living (ADL) and The Home Falls and Accidents Screening Tool (Home Fast). We saw how this translated into tangible outstanding outcomes for people. For example, for one person, they had originally been admitted into hospital having experienced a serious fall at home and broken their hip. They had previously enjoyed going out for meals and social events at a nearby social club. The injury had caused a loss of confidence and without the right intervention, there was a risk of increased social isolation and worse health outcomes. However, after a successful 7-week period of rehabilitation at the service, this person was able to return home safely and resume a level of activity as before the injury. We saw testimony from the person that whilst delighted to leave the service, they stated they would miss all the staff as they had made good friends with the team and described the service as ‘a wonderful place’.

For another person, we saw they had first been admitted into hospital for hip surgery, but whilst in hospital had become very unwell and spent a period in the intensive care unit. Once physically well enough, we saw this person had reluctantly agreed to be transferred to Killilea for rehabilitation. However, the first few weeks were difficult, and this person was dependant on staff to assist with most activities of daily living. Overtime, and with the incredible holistic support provided from social care staff, therapy and nursing colleagues this person reached a point where plans could be drawn up for a potential return home. This next phase of this person’s journey was also fraught with challenges and complexities, but within four and a half weeks this person went home not only more physically able, but their mood and overall wellbeing had vastly improved. We saw testimony from their person that they had made ‘friends for life’ during their stay.

For other people we spoke with during our assessment, feedback about their own journey and individual outcomes was equally exceptional. Comments from people and their relatives included, “I come in to see my [Relative] about 3 times a week. She had a hip replacement and has been here about 6 weeks, and when she came in, she couldn't even sit up in a chair. The staff have been amazing and over the last 2 weeks and [Person] is now able to stand and transfer from chair etc. Communication from here is excellent, physio is amazing but then all the staff are” and “I’ve been in for 4 days but previously had been in bed for 4 months at home and not walked at all. I am waiting for a hip replacement, but my consultant won’t do it until I can stand. I have already started physio every day including at the weekend.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff supported people to exercise their rights. Staff encouraged people to make decisions about aspects of their daily care routines, and staff told us they always obtained consent from the person before supporting them with personal care tasks.

People’s care plans contained assessments of people’s individual capacity to consent to specific decisions about their care. If people were unable to meaningfully consent, there was a framework to ensure appropriate best interest decisions were made and recorded in their care plans.